Social Skills Training to Reduce Depression in Adolescents
Reed, Michael K., Adolescence
Depression and depressive disorders remain a pervasive problem in Western society (Albert & Beck, 1975; Schulterbrandt & Raskin, 1977; Rehm, 1981). The extent to which this problem affects adolescents has recently generated substantial research (Kendall, Cantwell, & Kazdin, 1989; Kazdin, 1990). Both DSM-III and DSM-IIIR have employed the same criteria to define depression in adolescents as in adults. Applying these criteria to emotionally disturbed adolescents reveals that the depressive disorders are common (i.e., estimated incidence ranges from 15 to 30%) (Schulterbrandt & Raskin, 1977; Costello, 1981; Weiner, 1982; Kazdin, 1990).
Beck's Cognitive Theory of Depression (1979) has served as a heuristic model for understanding depressive disorders in several studies. Depression is described primarily as a disorder of cognition, resulting in impaired affect and$behavior (Beck, Rush, Shaw, & Emery, 1979).
The model explains how cognitive errors in interpersonal interactions lead an individual to view current life experiences primarily as negative, resulting in the development of the depressive syndrome. In addition, the model describes how applying idiosyncratic schemas to life circumstances maintains the depressive syndrome. Within this model, treatment of depression requires the modification of the client's cognitions. The treatment process is further facilitated by focusing on other components of the depressive syndrome (e.g., behavior). Treatments consistent with Beck's model of depression and its treatment have shown promise (Rehm, 1981; Kazdin 1990).
Social skills therapeutic programs are designed to alter maladaptive social/interpersonal behaviors as well as the inappropriate cognitive evaluations associated with social behavior. Appropriate social skills consist of: (1) the ability to organize cognitions and behaviors into an integrated course of action directed toward culturally acceptable social and/or interpersonal goals; and (2) the ability to continuously assess and modify goal-directed behavior to maximize the likelihood of reaching particular goals (Goldstein, 1981).
One specific social skills program, Structured Learning Therapy (SLT), presents a comprehensive treatment approach with adolescents (Goldstein, Spraffin, Gershaw, & Klein, 1980). SLT includes skill instruction, modeling, role playing, and performance appraisal. Goldstein (1981) defined his treatment as the planned systematic teaching of specific behaviors that help an individual function appropriately in interpersonal contexts. Along with behavior modification, the program strives to modify distorted perceptions about social interactions, as well as the individual's ability and potential. Research examining social skills treatments that contain procedures similar to SLT suggest that the treatment is effective for a variety of social/interpersonal problems. For example, SLT's efficacy has been reported for treating: social isolation and social withdrawal (Jackibchuk & Smeriglio, 1976; La Grecca & Sanogrossi, 1980); unassertive behavior (Denney, 1975; La Fromboise & Rowe, 1983); and aggressive behavior (Camp, Blom, Herbert, & Van Doormeade, 1977; Huey & Rank, 1984; Goldstein, Apter, & Harotunian, 1984). In addition, social skills treatments have been reported to be equal in effectiveness to traditional psychotherapies in treating depression and hyperactivity (Hersen, Bellack, Himmelhoch, & Thase, 1984; Fleming & Thornton, 1980; Kazdin, Esveldt-Dawson, & Matson, 1983).
Finally SLT appears to be more readily employable for various groups, compared to traditional psychotherapies, and has helped improve the psychosocial functioning of both males and females of diverse ages and ethnic backgrounds (La Fromboise & Rowe, 1983; Hersen et al., 1984; Huey & Rank, 1984). Consequently, social skills treatment may be a useful therapy for clients who have difficulty in traditional psychotherapy (e. …